Optical coherence tomography as a diagnostic aid to visual inspection and colposcopy for preinvasive and invasive cancer of the uterine cervix

Abstract

The purpose of this study was to determine the sensitivity and specificity of optical coherence tomography (OCT) under two well-defined clinical settings. First, as an aid to cervical cancer screening, using visual inspection with acetic acid (VIA) in low-resource settings, and the second, as an adjunct to the traditional management of abnormal cervical cytology with colposcopy and biopsy. Patients referred for colposcopy with > or = atypical squamous cells of undetermined significance were accrued for the study. Each subject underwent VIA and colposcopy. OCT was performed in all VIA- and colposcopy-positive areas and at the squamocolumnar junction in all four quadrants. The sensitivity of VIA for > or = cervical intraepithelial neoplasia 2 was 76% (95% CI 58-88). When OCT was applied to VIA as a secondary screen, the specificity improved from 34% (95% CI 27-41) to 61% (95% CI 60-74). With liberal diagnostic criteria for the majority of the colposcopy examinations, OCT showed an even greater relative improvement in specificity. OCT proved to be a fair diagnostic modality (receiver operating characteristic curve 0.73) adjunctive to VIA and colposcopy. On the basis of the above findings, we believe that this technology could potentially show greatest utility in the management of cervical dysplasia in low-resource settings where a single episode of care is most desirable.

Simultaneous optical coherence tomography and laser induced fluorescence imaging in rat model of ovarian carcinogenesis

“…OCT has previously been used in a variety of applications, including human eye, 11,12 gastrointestinal neoplasms, 13,14 and gynecologic neoplasms such as ovary, [15][16][17][18][19] endometrium [18][19][20] and cervix. 18,19,[21][22][23][24][25][26] Prior studies evaluating OCT imaging of human ovarian tissue have shown promising results as a diagnostic tool for ovarian cancer, demonstrating the ability to visualize fine architectural features of both normal ovaries and ovarian malignancies ex vivo [16][17][18] and in vivo via laparoscopic imaging. 15,19 Laser-induced fluorescence (LIF) spectroscopy is another non-destructive imaging modality with promising diagnostic capabilities in ovarian cancer.…”

Digital colposcopy: ready for use? An overview of literature

“…Overall, the sensitivity and specificity of (traditional) colposcopy for lesions ‡CIN2 in this study are 39% (95% CI 24-57) and 71% (95% CI 64-77), respectively, while the sensitivity and specificity of blinded OCT for this diagnosis are 56% (95% CI 39-72) and 59% (95% CI 52-66), respectively. 64 The sensitivity and specificity of colposcopy and OCT together for diagnosing HG lesions are 46% (95% CI 30-64) and 69% (95% CI 62-75), respectively. 64 So, this study suggests that OCT can improve the sensitivity of the colposcopic examination at a cost of a slightly lower specificity.…”

“…60,61 Since OCT is capable of providing images of tissue structures at a cellular level with a resolution of 10-20 mm, this technique holds promise for diagnosing cervical lesions without having to take a biopsy ('optical biopsy'). 59,[62][63][64][65] One study has been conducted to determine the sensitivity and specificity of OCT in which this technique is used as an adjunct to the traditional management of abnormal cytology with colposcopy and biopsy. 64 After completion of the examinations, all the OCT images were reviewed twice.…”

“…59,[62][63][64][65] One study has been conducted to determine the sensitivity and specificity of OCT in which this technique is used as an adjunct to the traditional management of abnormal cytology with colposcopy and biopsy. 64 After completion of the examinations, all the OCT images were reviewed twice. The first review of the images was performed blind, and the second review was performed with knowledge of the outcome of cytology and colposcopy results and viewing the digital photograph of the cervix.…”

Automated segmentation algorithm for detection of changes in vaginal epithelial morphology using optical coherence tomography

“…[1][2][3][4][5] To attempt to fight the HIV epidemic, microbicides, vaginal products for prevention of acquisition of the infection, have been developed. However, some of these products have been toxic to the genital tract, and more specifically, the cervicovaginal tract, and have increased or failed to prevent transmission of HIV.…”